Effects of Higher Versus Lower Threat Contexts on Pain-Related Visual Attention Biases: An Eye-Tracking Study of Chronic Pain.

In this research, we examined effects of higher versus lower threat contexts on attention biases in more and less pain-fearful chronic pain subgroups via eye-tracking methodology. Within a mixed chronic pain sample (69 women, 29 men), biases in orienting and maintenance of visual attention were assessed during the standardized image pair presentation phase (2,000 ms) of a modified visual dot probe task featuring painful-neutral (P-N) image pairs (lower threat context) and a parallel task in which these P-N pairs cued potential pain (higher threat context). Across both tasks, participants more often oriented toward, gazed longer at, and made more unique fixations upon pain images during P-N pair presentations. Although trait-based fear of pain was not related to any gaze bias index in either task, between task analyses indicated the sample reported more state fear, directed their initial gaze less often, and displayed longer overall gaze durations toward pain images in the higher threat context in which P-N trials signaled potential pain. Results supported the threat interpretation model premise that persons with chronic pain have difficulty disengaging from moderately threatening visual painful cues. PERSPECTIVE Through integrating dot-probe and impending pain task paradigms, we assessed effects of lower versus higher threat contexts on visual attention biases of persons with chronic pain via eye tracking. Under higher threat conditions featuring possible pain, state fear levels were elevated and maintenance of attention on painful depictions was more prolonged.